Prostate Cancer Update

Prostate Cancer Update: More U.S. physicians are sparing their low-risk cancer patients from surgery, radiation and hormone therapy in favor of monitoring their patients over time- a strategy called “watchful waiting”. The number of low-risk patients who didn’t undergo treatment jumped from as low as 7 % from 1990-2009 to 40 % from 2010-2013. These findings indicate that more patients are being monitored to see if their conditions get worse. In addition to finding a higher rate of watchful waiting in all men, those men aged 75 and older were much less likely to get potentially unnecessary treatment. Among low-risk men aged 75 and older, the rate of watchful waiting shot up from 22 % in 200-2004 to 50% in 2010-2013. As for patients at greatest danger, we are seeing more aggressive management of higher-risk disease with surgery, radiation or both, which is also a trend toward better management. The number of men who will die of prostate cancer because they chose active surveillance is not zero, but it is a very low number, far lower than those harmed by avoidable surgery, radiation, etc. The net health benefit for men with prostate cancer is likely to be more positive because we are treating the men who need treatment while avoiding the risk of side effects for those who don’t. These include incontinence and impotence. In older men, some cancers are slow growing and less likely to cause problems.